The ASCs specifically operated by larger hospitals are referred to as hospital outpatient departments (HOPDs). Despite this change, the ASC industry still reports revenues of approximately $24 billion, with an annual growth rate of 5%-a financial opportunity which many large practices, companies, and hospital systems have recognized in recent years ( 7). However, since the adoption of the Affordable Care Act (ACA), reimbursements to ASCs have become approximately 42% less when compared to hospitals for the same procedure-a phenomenon which has blunted the growth and widespread use of ASCs ( 2, 5- 8). Between 19, there was a massive growth of ASCs because reimbursement rates were slightly higher when compared to those received by hospitals. This approach allows ASCs to reduce the overall perioperative costs of surgery-largely those associated with post-operative care-while still being able to produce equivalent outcomes and maintain a high rate of patient satisfaction ( 2, 5- 7). ASCs exclusively provide outpatient surgeries (same-day or 23-h stay) which typically focus on a small subset of routine procedures and treatments. In 2017, more than 50% of all outpatient surgeries were conducted in ambulatory surgery centers (ASCs)-a market which is projected to reach $40 billion in 2020 ( 6).ДЄt the center of this massive growth are ASCs. Since then, the number of surgeries performed as outpatient procedures has increased dramatically from 3.7 million in 1981 to over 32.0 million in 2005 ( 5). In 1983, medicare introduced the inpatient prospective payment system in the hopes that hospitals and physicians would start to provide more patient care in the outpatient setting. With these numbers predicted to grow at an annual rate of 5.5%, the Centers for Medicare and Medicaid Services (CMS) have been piloting new programs and payment systems to reduce costs and incentivize physicians and healthcare organizations to provide cost-effective care ( 2- 4). The total health care expenditure in 2017 was $3.5 trillion dollars-an increase of 3.9% over the previous year and up from $2.6 trillion in 2010 ( 1, 2).

Medicare 2019 asc approved procedures